Weighing the Benefits of Medical Marijuana

DENVER – The federal government classifies marijuana as a dangerous, “Schedule One” drug with no accepted medical use, but now the American Medical Association is challenging that classification and calling for more research into the benefits and side effects of cannabis.

Inside The Health Center, a medical marijuana dispensary on South Colorado Boulevard in Denver, Ryan Vincent tells his patients about those side effects.

“You’re gonna have hunger, sleep, nausea suppression, pain management, you’re gonna have some short-term memory loss, and the worst probably side effect is if you are still smoking, the carcinogens are not good for you. So, it could cause cancer,” Vincent said.

Vincent is also quick to point out the potential benefits of medical marijuana, some of which he knows first hand.

“I completely lost vision. I was completely blind for about 2 1/2 years,” he said.

Vincent has suffered from severe eye problems for about 15 years, including ocular pressure and thousands of blisters on his eyes. He is still blind in his left eye. Vincent says he and his doctors have tried every type of prescription eye drop available without success.

“All of them have preservatives,” he said. “The problem with that with me is that as soon as I put that drop in my eye, my eyes swell shut.”

Vincent eventually decided marijuana was the only thing that helped, but he is quick to say he doesn’t smoke the drug. He uses a vaporizer that releases the active compounds in marijuana without producing some of the harmful carcinogens.

“I actually found that forced air vaporization, I can turn it on and actually blow it into my eye, and it can alleviate the pressure in almost five seconds. That kind of relief, I can’t even explain it, he said”

Vincent’s dispensary, The Health Center, offers more than just the green, leafy form of marijuana. He says a cream is great for arthritis patients, an oil helps with pain and edibles work great for cancer patients who need nausea suppression and increased appetite.

The Health Center doesn’t offer pipes because workers there do not encourage smoking.

Pulmonologist David Beuther at National Jewish Health is most concerned by the effects of burning marijuana leaves and inhaling the smoke.

“If you smoke regularly, say one or two joints a day on a chronic basis, that’s probably no better than and perhaps even worse than smoking a pack of cigarettes a day,” Beuther said. “So, the risk of lung cancer is increased by five or six fold.”

Beuther says smoking the drug can also lead to chronic bronchitis, wheezing, coughing and possibly emphysema. But even if a patient is not smoking cannabis, there can still be some serious side effects.

A review by Wayne Hall and Louisa Degenhardt of almost 100 epidemiological, clinical and laboratory studies was published in The Lancet in 2009.

Hall and Degenhardt concluded naïve users can experience anxiety and panic, but those side effects lessen with more experienced users.

Hall and Degenhardt also reviewed five studies that showed higher rates of psychiatric disorders, especially schizophrenia, among cannabis users.

Four separate studies that looked at motor vehicle accidents concluded that drivers who had THC in their blood had a higher accident risk than drivers without THC. However, the risk is not as great as it is with alcohol. Hall and Degenhardt concluded that “driving after having taken cannabis might increase the risk of motor vehicle crashes 2-3 times compared with 6-15 times with alcohol.”

These and other studies have led Beuther to tell his patients, “Perhaps it’s not as strong of a risk factor for accidents as alcohol, but it’s clearly there. So, you aren’t safe smoking marijuana and driving or operating big machinery.”

Marijuana can also affect patients’ memory and attention. “Cognitive Functioning of Long-term Heavy Cannabis users Seeking Treatment” by Dr. Nadia Solowij and colleagues was published in the Journal of the American Medical Association in 2002 and studied more than 100 cannabis users and nonuser controls. This study found that “long-term heavy cannabis users show impairments in memory and attention that endure beyond the period of intoxication and worsen with increasing years of regular cannabis use.”

Beuther agrees there can be issues with concentration, cognition and memory function “that we do sometimes see with cigarettes quite honestly over time, but seem to apply to marijuana as well. So, your brain might not work as well.”

Studies seeking to determine whether memory function returns when patients stop using marijuana have published differing results. Some suggest brain functions and IQ return completely, and other studies have suggested that functions remain slightly diminished, especially for heavy users.

Addiction can also be an effect of marijuana use. Hall and Degenhardt say, “cannabis dependence is the most common type of drug dependence after that on alcohol and tobacco. It has affected 1-2% of adults in the past year.” This study refers to all adults, not just cannibis users.

Wilson Compton and colleagues agreed with that rate in a study published in the Journal of the American Medical Association in 2004. The authors concluded marijuana dependence “significantly increased between 1991-1992 (1.2%) and 2001-2002 (1.5%).”

Even studies examining the lung cancer risk of smoking cannabis can conflict. A study by Mia Hashibe and colleagues published in Cancer Epidemiology, Biomarkers & Prevention in 2006 showed that while marijuana smokers in Los Angeles County had higher rates of lung, head and neck cancers, those positive associations disappeared when the authors controlled for confounding factors including cigarette smoking. The experts concluded, “Our results may have been affected by selection bias or error in measuring lifetime exposure and confounder histories, but they suggest that the association of these cancers with marijuana, even long-term or heavy use, is not strong and may be below practically detectable limits.”

A review by Wayne Hall, MacDonald Christie and David Currow published in The Lancet further agrees that the science is inconclusive concerning many of these side effects. The authors say that while some studies suggest an increased risk of upper-respiratory tract cancers, other studies have not found this risk.

Ryan Vincent advises his patients to try many different strains of marijuana and to keep a log of any side effects they experience. Vincent says different strains and delivery methods can cause very different levels of anxiety, pain relief, nausea suppression and other effects. He advises patients to work with their medical marijuana provider to maximize the benefits and minimize any negative side effects.  Source.

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